Intraplaque High-Intensity Signal on 3D Time-of-Flight MR Angiography Is Strongly Associated with Symptomatic Carotid Artery Stenosis

Gupta, Ajay; Baradaran, Hediyeh; Kamel, Hooman; Mangla, Atul; Pandya, Ankur; Fodera, V.; Dunning, Allison; Sanelli, Pina C.

doi:10.3174/ajnr.a3732

Cited by 27 publications

(26 citation statements)

References 23 publications

(42 reference statements)

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“…On the T1-weighted fat-saturated images, we observed a crescentic hyperintense signal (Fig 2A) consistent with hemorrhage. 3,4 The finding of Choi et al 1 of hemorrhage in 2 of the 4 patients for which carotid endarterectomy specimens were available is consistent with our findings on T1-weighted black-blood imaging in this patient. Axial source images from the 2D TOF image (Fig 2B) demonstrated abnormal flow-related enhancement in the area of the known web, possibly due to diminished or turbulent flow.…”

supporting

confidence: 90%

Carotid Web: Appearance at MR Angiography

Lantos

Chazen

Gupta

2015

AJNR Am J Neuroradiol

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supporting

confidence: 90%

Carotid Web: Appearance at MR Angiography

Lantos

Chazen

Gupta

2015

AJNR Am J Neuroradiol

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“…These include conventional T1-weighted fast spin echo, TOF MRA, or MPRAGE sequences. Several studies have used TOF sequencing to detect carotid IPH, and a routine MRA protocol without additional sequences to evaluate carotid atherosclerosis (1,5,9,15). The appearance of a halo sign around the carotid artery on the MIP of the TOF MRA was useful for the noninvasive detection of a fresh or recent carotid IPH on histologic analysis (6,9).…”

Section: Discussionmentioning

confidence: 99%

Carotid Intraplaque Hemorrhage Imaging: Diagnostic Value of High Signal Intensity Time-of-Flight MR Angiography Compared with Magnetization-Prepared Rapid Acquisition with Gradient-Echo Sequencing

Ahn

Kwak

Chung

et al. 2018

Investig Magn Reson Imaging

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“…Several investigators have reported an association between the presence of carotid IPH and cerebral ischemic events [25][26][27][28][29] . Hosseini et al [28] performed meta-analysis and showed a strong association between the presence of carotid IPH and recurrent cerebral ischemic events in symptomatic carotid artery stenosis (OR 12.2, 95% CI 5.5-27.1, p < 0.001), thereby suggesting that IPH is a promising predictor of future cerebrovascular events in patients with carotid artery stenosis.…”

Section: Discussionmentioning

confidence: 99%

High-Intensity Signal in Carotid Plaque on Routine 3D-TOF-MRA Is a Risk Factor of Ischemic Stroke

Yamada¹,

Kawasaki

Yoshimura

et al. 2015

Cerebrovasc Dis

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Background: Carotid atherosclerotic disease is recognized as an important risk factor for brain ischemic events. However, high-grade stenosis does not always cause ischemic strokes, whereas moderate-grade stenosis may often cause ischemic strokes. It has been reported that there is an association between carotid intraplaque hemorrhage (IPH) and new cerebral ischemic events. The purpose of this study was to elucidate the relationship between high-intensity signals (HIS) on maximum intensity projection (MIP) images from routine 3-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and prior ischemic strokes in the patients with moderate carotid stenosis. Materials and Methods: Sixty-one patients with moderate carotid artery stenosis (50-69% stenosis based on North American Symptomatic Carotid Endarterectomy Trial criteria) were included. Carotid IPH was defined as the presence of HIS in carotid plaques on MIP images detected by 3D-TOF-MRA using criteria we previously reported. We analyzed the relationship between the presence of HIS in plaques and prior ischemic strokes defined as ischemic lesions on diffusion-weighted brain images. Results: HIS in carotid plaques were present in 27 (44%) of 61 patients. Prior ipsilateral ischemic strokes occurred more frequently in the HIS-positive group than the HIS-negative group (67 vs. 9%, p < 0.001). Furthermore, there were more smokers in the group with ischemic stroke than without it (62 vs. 25%, p = 0.005). In multivariate logistic regression analysis, HIS in carotid plaque (OR 23.4, 95% CI 4.62-118.3, p < 0.001) and smoking (OR 5.44, 95% CI 1.20-24.6, p = 0.028) were independent determinants of prior ischemic strokes after adjustment for age. Conclusions: HIS in carotid plaques on 3D-TOF-MRA MIP images are independent determinants of prior ischemic strokes in patients with moderate carotid artery stenosis, and they can potentially provide a reliable risk stratification of patients with moderate carotid artery stenosis.

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Intraplaque High-Intensity Signal on 3D Time-of-Flight MR Angiography Is Strongly Associated with Symptomatic Carotid Artery Stenosis

Cited by 27 publications

References 23 publications

Carotid Web: Appearance at MR Angiography

Carotid Web: Appearance at MR Angiography

Carotid Intraplaque Hemorrhage Imaging: Diagnostic Value of High Signal Intensity Time-of-Flight MR Angiography Compared with Magnetization-Prepared Rapid Acquisition with Gradient-Echo Sequencing

High-Intensity Signal in Carotid Plaque on Routine 3D-TOF-MRA Is a Risk Factor of Ischemic Stroke

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